Chapter 32 Workbook Flashcards by Tom Bowl

A fracture causing deformity or distortion of the injured limb

Displaced fracture

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Any fracture in which the skin has not been broken

Closed fracture

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A thin layer of cartilage covering the articular surface of bones in synovial joints

Articular cartilage

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An involuntary form of muscle found in the gastrointestinal (GI) tract, blood vessels, and other tubular structures of the body

Smooth muscle

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Any break in the bone in which the overlying skin has also been damaged

Open fracture

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Bands of fibrous tissue that strengthen joint capsules

Ligaments

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Also called striated or voluntary muscle because it is under direct voluntary control of the brain

Skeletal muscle

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Where two bones come into contact

Joint

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The act of pulling on a body structure in the direction of its normal alignment

In-line traction

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Fibrous tissue that covers all skeletal muscle

Fascia

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Pain elicited by palpation with a finger at the site of an injury

Point tenderness

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Blood in the urine is known as:
A. hematuria
B. hemoptysis
C. hematocrit
D. hemoglobin

A. hematuria

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Smooth muscle is found in the:
A. back
B. blood vessels
C. heart
D. leg

B. blood vessels

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The bones in the skeleton produce ________ in the bone marrow.
A. blood cells
B. minerals
C. electrolytes
D. hormones

A. blood cells

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________ are held together in a tough fibrous structure known as a capsule.
A. Tendons
B. Joints
C. Ligaments
D. Bones

B. Joints

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Joints are bathed and lubricated by ________ fluid.
A. cartilaginous
B. articular
C. synovial
D. cerebrospinal

C. synovial

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A ________ is a disruption of a joint in which the bone ends are no longer in contact.
A. torn ligament
B. dislocation
C. fracture-dislocation
D. sprain

B. dislocation

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A ________ occurs when a joint is twisted or stretched beyond its normal range of motion.
A. dislocation
B. strain
C. sprain
D. torn ligament

C. sprain

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A ________ is a stretching or tearing of the muscle and/or tendon.
A. strain
B. sprain
C. torn ligament
D. split

A. strain

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The zone of injury includes all of the following EXCEPT:
A. adjacent nerves
B. adjacent blood vessels
C. surrounding soft tissue
D. the incident scene

D. the incident scene

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A(n) ________ fractures the bone at the point of impact.
A. direct blow
B. indirect force
C. twisting force
D. high-energy injury

A. direct blow

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A(n) ________ may cause a fracture or dislocation at a distant point.
A. direct blow
B. resultant force
C. twisting force
D. high-energy injury

B. resultant force

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When caring for patients who have fallen, you must identify the ________ and the mechanism of injury so that you will not overlook associated injuries.
A. site of injury
B. height of fall
C. point of contact
D. twisting forces

C. point of contact

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________ produce severe damage to the skeleton, surrounding soft tissues, and vital internal organs.
A. Direct blows
B. Indirect forces
C. Twisting forces
D. High-energy injuries

D. High-energy injuries

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Regardless of the extent and severity of the damage to the skin, you should treat any injury that breaks the skin as a possible: A. closed fracture B. open fracture C. nondisplaced fracture D. displaced fracture

B. open fracture

A(n) ________ is also known as a hairline fracture. A. closed fracture B. open fracture C. nondisplaced fracture D. displaced fracture

C. nondisplaced fracture

A(n) ________ produces actual deformity, or distortion, of the limb by shortening, rotating, or angulating it. A. closed fracture B. open fracture C. nondisplaced fracture D. displaced fracture

D. displaced fracture

You respond to a 19-year-old woman who was kicked in the leg by a horse. She is alert and oriented. Respirations are 20 breaths/min, regular and unlabored. Pulse is 110 beats/min and regular. Distal pulses are present. She has point tenderness at the site of the injury. You should compare the limb to: A. the opposite uninjured limb B. one of your limbs or one of your partner’s limbs C. an injury chart D. other limb injuries you have seen

A. the opposite uninjured limb

________ is the most reliable indicator of an underlying fracture. A. Crepitus B. Deformity C. Point tenderness D. Absence of distal pulse

C. Point tenderness

A(n) ________ fracture occurs in a growth section of a child’s bone, which may prematurely stop growth if not properly treated. A. greenstick B. comminuted C. pathologic D. epiphyseal

D. epiphyseal

A(n) ________ fracture is an incomplete fracture that passes only partway through the shaft of a bone but may still cause severe angulation. A. greenstick B. comminuted C. pathologic D. epiphyseal

A. greenstick

You are called to the local assisted living facility where a 94-year-old man has fallen. He is alert and oriented and denies passing out. His respirations are 18 breaths/min and regular. Pulse is 106 beats/min, regular and strong. Distal pulses are present. He states that he was walking, heard a pop, and fell to the floor. You suspect a(n) ________ fracture. A. greenstick B. comminuted C. pathologic D. epiphyseal

C. pathologic

A(n) ________ fracture is a fracture in which the bone is broken into more than two fragments. A. greenstick B. comminuted C. pathologic D. epiphyseal

B. comminuted

Your 24-year-old patient fell off a balance beam and landed on his arm. He is complaining of pain in the upper arm, and there is obvious swelling. You know that swelling is a sign of: A. bleeding B. laceration C. a locked joint D. compartment syndrome

A. bleeding

Fractures are almost always associated with ________ of the surrounding soft tissue. A. laceration B. crepitus C. ecchymosis D. swelling

C. ecchymosis

Signs and symptoms of a dislocated joint include all of the following EXCEPT: A. marked deformity B. tenderness or palpation C. locked joint D. ecchymosis

D. ecchymosis

Signs and symptoms of sprains include all of the following EXCEPT: A. point tenderness B. pain preventing the patient from moving or using the limb normally C. marked deformity D. instability of the joint indicated by increased motion

C. marked deformity

Which of the following is NOT considered one of the 6 Ps of the musculoskeletal assessment? A. Pain B. Pulselessness C. Pressure D. Peristalsis

D. Peristalsis

Which of the following statements about compartment syndrome is FALSE? A. It occurs 6 to 12 hours after an injury. B. It most commonly occurs with a fractured femur. C. It is usually a result of excessive bleeding, a severely crushed extremity, or the rapid return of blood to an ischemic limb. D. It is characterized by pain that is out of proportion to the injury.

B. It most commonly occurs with a fractured femur.

Checking neurovascular function is required at all of the following times EXCEPT: A. after any manipulation of the limb B. before applying a splint C. after applying a splint D. during history taking

D. during history taking

You respond to a 19-year-old woman who was involved in a motor vehicle collision. She is alert and oriented. Her airway is open, and respirations are 18 breaths/min and unlabored. Pulse is 94 beats/min and is strong and regular. Distal pulses are present. Her upper arm has obvious deformity. You splint the upper arm. You know that splinting will do all of the following EXCEPT: A. prevent the need for surgery B. make it easier to transfer the patient C. help prevent restriction of distal blood flow D. reduce pain

A. prevent the need for surgery

In-line ________ is the act of exerting a pulling force on a body structure in the direction of its normal alignment. A. stabilization B. immobilization C. traction D. direction

C. traction

Which of the following is NOT a basic type of splint? A. Rigid B. Formable C. Pelvic binder D. Sling

D. Sling

For which of the following should you use a traction splint? A. Injuries of the pelvis B. An isolated femur fracture C. Partial amputation or avulsions with bone separation D. Lower leg or ankle injury

B. An isolated femur fracture

All of the following are hazards of improper splinting EXCEPT: A. an increase of distal circulation B. a delay in the transport of a patient with a life-threatening injury C. a reduction of distal circulation D. a compression of nerves, tissues, and blood vessels

A. an increase of distal circulation

The ________ is one of the most commonly fractured bones in the body. A. scapula B. clavicle C. humerus D. radius

B. clavicle

What joint is frequently separated during football and hockey when a player falls and lands on the point of the shoulder? A. Glenohumeral joint B. Acromioclavicular joint C. Sternoclavicular joint D. Sacroiliac joint

B. Acromioclavicular joint

Signs and symptoms associated with hip dislocation include all of the following EXCEPT: A. severe pain in the hip B. lateral and posterior aspects of the hip region are tender on palpation C. being able to palpate the femoral head deep within the muscles of the buttock D. decreased resistance to any movement of the joint

D. decreased resistance to any movement of the joint

There is often a significant amount of blood loss, as much as ________ mL, after a fracture of the shaft of the femur. A. 100 to 250 B. 250 to 500 C. 500 to 1,000 D. 1,000 to 1,500

C. 500 to 1,000

The knee is especially susceptible to ______ injuries, which occur when abnormal bending or twisting forces are applied to the joint. A. tendon B. ligament C. dislocation D. fracture-dislocation

B. ligament

Signs and symptoms of knee ligament injury include all of the following EXCEPT: A. swelling B. point tenderness C. joint effusion D. the affected leg being externally rotated

D. the affected leg being externally rotated

Although substantial ligament damage always occurs with a knee dislocation, the more urgent injury is to the ______ artery, which is often lacerated or compressed by the displaced tibia. A. tibial B. femoral C. popliteal D. dorsalis pedis

C. popliteal

Because of local tenderness and swelling, it is easy to confuse a nondisplaced or minimally displaced fracture at the knee with a: A. tendon injury B. ligament injury C. dislocation D. fracture-dislocation

B. ligament injury

Fractures of the tibia and fibula are sometimes associated with ______ as a result of the distorted positions of the limb following injury. A. vascular injury B. muscular injury C. tendon injury D. ligament injury

A. vascular injury

Dislocation of the ______ is usually associated with fractures of one or both malleoli. A. knee B. elbow C. ankle D. hip

C. ankle

True/False All extremity injuries should be splinted before moving a patient unless the patient’s life is in immediate danger.

True

True/False Splinting reduces pain and prevents the motion of bone fragments.

True

True/False It may be necessary to force bone fragments back into place when applying traction.

False

True/False When applying traction, the direction of pull is in the direction of the limb’s normal alignment.

True

True/False Cover wounds with a dry, sterile dressing before applying a splint.

True

True/False When splinting a fracture, you should be careful to immobilize only the joint above the injury site.

False

True/False One of the steps of the neurologic examination is to palpate the pulse distal to the site of injury.

True

True/False White blood cells and platelets are produced in the marrow cavity.

True

True/False Compartment syndrome can develop in the forearm in children with a fracture of the humerus.

True

True/False Fractures of the distal radius are known as Colles fractures.

True

The __________ is the largest of the tarsal bones.

calcaneus

Bone marrow produces __________ __________.

blood cells

The humerus connects with the radius and ulna to form the __________ elbow joint.

hinged

The __________ is a slender, S-shaped bone attached by ligaments to the sternum on one end and to the acromion process on the other.

clavicle

A patient who has a significant __________ __________ __________ but whose condition appears otherwise stable should also be transported promptly to the closest appropriate hospital.

mechanism of injury

Any damage or open wound in the skin should alert you to the possibility of a(n) __________ __________.

open fracture

The __________ __________ is the largest peripheral nerve in the body; it controls the activity of muscles in the thigh and below the knee.

sciatic nerve

__________ __________are used to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and pain.

Pelvic binders

A grating or grinding sensation known as __________ can be felt and sometimes even heard when fractured bone ends rub together.

crepitus

A dislocated joint sometimes will spontaneously __________, or return to its normal position.

reduce

If you suspect that a patient has compartment syndrome, splint the affected limb, keeping it at the level of the heart, and provide immediate transport, reassessing __________ __________frequently during transport.

Neurovascular status

Pectoral Girdle A. Sternoclavicular joint B. Clavicle C. Acromioclavicular joint D. Manubrium E. Acromion process F. Humerus G. Sternum H. Glenohumeral (shoulder) joint I. Acromion process J. Glenoid fossa K. Humerus L. Scapula

Anatomy of the Wrist and Hand A. Index B. Long C. Ring D. Little E. Phalanges F. Thumb G. Metacarpals H. Scaphoid I. Carpals J. Radius K. Ulna

Bones of the Thigh, Leg, and Foot A. Pelvis (hip bone) B. Hip C. Femur D. Thigh E. Patella (kneecap) F. Knee G. Fibula H. Leg I. Tibia (shin bone) J. Ankle K. Tarsals (ankle) L. Foot M. Metatarsals N. Phalanges

Short Answers List the four types of forces that may cause injury to a limb.

1. Direct blows 2. Indirect forces 3. Twisting forces 4. High-energy injuries

Short Answers List at least five of the signs associated with a possible fracture.

* Deformity * Tenderness (point) * Guarding * Swelling * Bruising * Crepitus * False motion * Exposed fragments * Pain * Locked joint

Short Answers List the 6 Ps of musculoskeletal assessment.

1. Pain 2. Paralysis 3. Paresthesia (numbness or tingling) 4. Pulselessness 5. Pallor 6. Pressure

Short Answers List the general principles of splinting.

1. Remove clothing from the area. 2. Note and record the patient’s neurovascular status distal to the site of the injury. 3. Cover all wounds with a dry, sterile dressing before splinting. 4. Do not move the patient before splinting. 5. For a suspected fracture of the shaft of any bone, immobilize the joints above and below the fracture. 6. For a joint injury, immobilize the bones above and below the injured joint. 7. Pad all rigid splints. 8. Maintain manual immobilization to minimize movement of the limb and to support the injury site. 9. If a fracture of a long-bone shaft has resulted in severe deformity, use a constant, gentle manual traction to align the limb. 10. If you encounter resistance to limb alignment, splint the limb in its deformed position. 11. Stabilize all suspected spinal injuries in a neutral in-line position on a backboard. 12. If the patient has signs of shock, align the limb in the normal anatomic position, and provide transport. 13. When in doubt, splint.

Short Answers What are the three goals of in-line traction?

1. Stabilize the fracture fragments to prevent excessive movement. 2. Align the limb sufficiently to allow it to be placed in a splint. 3. Avoid potential neurovascular compromise.

Ambulance Calls You are dispatched to care for a 17-year-old boy who jumped from the top of a three-story home into a pool. He landed directly on his feet just short of the pool. He is now complaining of low back pain and numbness and tingling of his legs. How would you best manage this patient?

This patient likely has a compression injury to his lumbar spine. The force exerted on his body from the landing will be transferred up from his feet through his legs to his pelvis and spine. You must take all spinal precautions, apply high-flow oxygen, and provide prompt transport to the nearest appropriate facility. Continue to monitor any changes in the pulse, motor, and sensation, specifically in his lower body.

Ambulance Calls You are called to a local park where an 11-year-old girl fell off the parallel bars onto her right elbow. She is cradling the arm to her chest. She has obvious swelling and deformity in the area. She has good pulse, motor, and sensation at the wrist. ABCs are normal. How would you best manage this patient?

Because circulation is intact, splint the arm in the position found. Use a board splint for support with a sling and swathe. Immobilize the hand in the position of function. Apply oxygen as needed and transport the patient in a position of comfort. Provide normal transport and monitor vital signs and neurovascular function.

Ambulance Calls You are dispatched to a fall at a local personal care home. You arrive to find an 82-year-old female complaining of severe pain in her right hip, and the right leg is extended straight out and externally rotated. How would you best manage this patient?

This patient presents with signs of an anterior hip dislocation. Do not attempt to reduce the dislocation. It is preferable to use a scoop stretcher to move the patient to avoid any further injury. Manage her ABCs and give oxygen as needed. Assess for a pulse in the right foot before and after moving. Splint the dislocation in the position found, and place the patient supine on the backboard using a scoop stretcher to lift her. Support her right leg with pillows and rolled blankets, then secure the entire limb to the backboard with long straps so that the hip region will not move. Provide prompt transport and reassess frequently.

You respond to a motorcycle accident for a 41-year-old man who is unconscious. He has obvious deformity to both lower legs and is bleeding moderately from an open fracture. His airway is open, and he is making gurgling noises. Pulse is rapid and weak. Distal pulses are very weak. Your first priority with this patient is to: A. control life-threatening bleeding B. apply splints C. maintain an airway D. apply a pneumatic antishock garment

A. control life-threatening bleeding

You respond to a motorcycle accident for a 41-year-old man who is unconscious. He has obvious deformity to both lower legs and is bleeding moderately from an open fracture. His airway is open, and he is making gurgling noises. Pulse is rapid and weak. Distal pulses are very weak. You have loaded the patient and are en route to the hospital. You have secured the airway and immobilized the fractures. How often should you reassess his vital signs? A. Every 3 minutes B. Every 5 minutes C. Every 10 minutes D. Every 15 minutes

B. Every 5 minutes

You are called to the local junior high school where a 12-year-old boy fell and hurt his wrist. There is obvious deformity. He is alert and oriented. Respirations and pulse are within normal limits. Distal pulse is present. It is important to remember to: A. use a zippered air splint B. splint in a position of function C. splint the wrist only D. completely cover the wrist and hand

B. splint in a position of function

When you have applied a traction splint and confirmed that pulse, motor, and sensory function are intact, the last thing that you do is: A. call in your patient report to the hospital B. release traction if the pulse disappears C. apply elasticized straps D. secure the patient to a backboard

D. secure the patient to a backboard

Chapter 32 Workbook Flashcards

(91 cards)